Can anyone help me with the scenario? I'm very confused about the answer my class says is correct. Does a record HAVE to come right out and state that it is hemodialysis in order to be considered that?

CC:This patient comes in today with a request by Dr. Brown to see if this patient's dialysis AV fistula should be removed and, if so, for removal.

HPI:In the past 2 months, patient has had a few infections in the AV fistula that have caused problems with his health. He has been on antibiotics to clear up the current infection.


General:Doing well

Vital Signs:Patient weight is 170, BP 130/90, and P is 80.


Neck:Supple, no swollen lymph nodes, no carotid bruits.


Heart:Heart sounds are normal.


Extremities:The AV fistula is slightly pink but the infection appears to be clearing up.

ASSESSMENT:The AV fistula should come out. I will do this today. A replacement will need to go back in, but not today.

PROCEDURE:After informed consent, the left-side PernCath dialysis catheter was removed. Using a local anesthesia, 1% lidocaine, and Betadine for sterilization, incision was made at the site of entry, then I sharply dissented the tissues around. I was able to carefully dissect all the way up to the puncture site, then proceeded to remove the catheter. The wound was closed and a pressure dressing was then applied to the wound. Patient was instructed to go to the ER if there is any bleeding. The patient tolerated the procedure well. A note was sent to Dr. Brown.

Now for this scenario I'm getting that this was a hemodialysis catheter that was removed. My logic in this is 1.) It states it was in an extremity. 2.) I cannot find anywhere that states an AV fistula is used for peritoneal dialysis.

My problem is that I'm being told it was peritoneal dialysis. I'm told the diagnosis for this would be 996.68, which is for an infection due to peritoneal dialysis.

This is why I'm confused on this one. How can you have hemodialysis and yet use a code for peritoneal dialysis? Or am I totally missing something about the two different types of dialysis?